论文部分内容阅读
目的探讨阻塞性睡眠呼吸暂停综合征(OSAS)对脂质代谢的影响。方法选择OSAS患者90例,根据低通气指数(AHI)和SaO2的变化分为轻、中、重度,同时人选正常对照组30例,均行多导睡眠监测仪(PSG)检查,并进行血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白-A(Aapo-A)、载脂蛋白-B(Apo-B)、脂蛋白-α[Lp(α)]、空腹血糖(FBG)的测定,比较各组之间的差异。另外,从中、重度组患者中各随机抽取15例进行持续正压通气(CPAP)治疗,两周后复查生化指标并比较治疗前、后的变化。结果OSAS组空腹TC、TG、LDL-C、Apo-B及FBG明显高于对照组,并随OSAS程度加重而增高。重度OSAS组Apo-A较正常组明显减低,HDL-C有随OSAS程度加重而降低的趋势,但无统计学意义。TC、LDL-C、FBG与BMI、AHI呈正相关,Apo-A与BMI、AHI为负相关,而HDL-C仅与BMI负相关。经CPAP治疗两周后TC、TG、LDL-C、FBG显著降低,Apo-A明显升高。结论AHI、BMI与OSAS患者血脂代谢紊乱相关并可以经过CPAP治疗逆转。
Objective To investigate the effect of obstructive sleep apnea syndrome (OSAS) on lipid metabolism. Methods Ninety OSAS patients were selected and divided into mild, moderate, and severe normal control group according to changes of low aeration index (AHI) and SaO2. All patients were examined by polysomnography (PSG) and total serum TC, TG, HDL-C, LDL-C, Aapo-A, Apo-B (Apo-B), lipoprotein-α [Lp (α)] and fasting blood glucose (FBG) were measured and the differences among groups were compared. In addition, 15 patients were randomly selected from the moderate and severe groups to undergo continuous positive airway pressure (CPAP) treatment. Two weeks later, the biochemical indexes were reviewed and compared before and after treatment. Results The levels of fasting TC, TG, LDL-C, Apo-B and FBG in OSAS group were significantly higher than those in control group, and increased with the severity of OSAS. Severe OSAS group Apo-A was significantly lower than the normal group, HDL-C with OSAS degree increased and decreased, but not statistically significant. TC, LDL-C, FBG and BMI, AHI was positively correlated, Apo-A and BMI, AHI was negatively correlated, while HDL-C only negatively correlated with BMI. TC, TG, LDL-C and FBG decreased significantly and Apo-A increased significantly after CPAP treatment for two weeks. Conclusion AHI, BMI and OSAS patients with dyslipidemia related and can be reversed after CPAP treatment.